Can a trust protect mom's assets from Medicaid?

I guess I'm "sanctimonious" and "out of my financial mind" bc I chose to use my parents savings for excellent private care in AL and then Memory Care Assisted Living for mom. Even though the 5 year look back had expired in 2019 and I could have applied for Medicaid for mom, I did everything in my power to AVOID that bc she'd have had a roommate and shared bathroom in a SNF which she'd have hated, etc. The result was that I got no inheritance but my folks received the best of care and mom had private accommodations and total dignity until the day she died in 2022. So did dad.

It is difficult to understand the comments about "the taxpayers being on the hook." Presumably at some point, the loved one was also one of those "taxpayers." They paid into the system, like everyone else, and in many cases paid more into "the system" than others. Then, because in some manner they have been successful (whether on their own or by some other form of inheritance), "the system" says "you will not benefit from the system you paid into." You will go bankrupt paying for your own care and leave nothing for your family. You played by the rules. You did well........congratulations.......here is a giant "raspberry" from "the system." So crazy....a legalized form of a Ponzi scheme.....pay in with the promise of future benefit.......and then when you get there, there is nothing for you. Sorry, but if you paid into "the system" like everyone else, you should benefit from "the system." You and your family should not be penalized because you have done well in some manner. It is a complicated, difficult system that is stacked against those who do well for themselves. That is why people "play the game." That is why there are attorneys who specialize in this kind of thing.....because the system is set up for people to "play it" by the rules and benefit from "the system" they paid into. Usually the people who get stuck are the ones in the middle. The ones with nothing have nothing to lose. The ones with a lot can afford to pay for attorneys, hide their assets (legally according to the rules) and not get stuck with nothing in the end. It is the ones in the middle that really get stuck. Just enough assets to take care of the loved one for awhile but not enough to find ways to legally shelter the funds. You spend and spend on the care and drain the resources you have before you ever have an opportunity to benefit from the system that you paid into. So, I don't really understand all of the comments about "the taxpayers" footing the bill.........."we have met the taxpayer, and it is us." I would really have more interest in hearing why people believe that it is okay for people to pay into the system for years and then get punished at the end of their lives because they have done well and played by the rule.

Your Mom's assets stand to give your Mom the care she needs. Protecting assets for future generations while the taxpayer pays the bill isn't necessarily the way to go, and folks often get in deep weeds trying to protect assets with Trusts and with irrevocable trust which I call "Giving away the farm".

So don't go to some seminar with someone to sell you something. Instead get a certified elder law attorney would be step A. The attorney has a LEGAL FIDUCIARY responsibility to help you and not to misguide you.

Then take in all your Mom's assets and all the details of your Mom. Her age, her condition mentally and medically, her needs now and forseen in future.

Then you ask what protective paperwork she needs to have for herself, and what recommendations he has for her given her future plans in so far as she is able to foresee them (knowing that the UNforeseen will always be hiding in the shadows.

The attorney will guide you with questions. Just have all Mom's info with you.

That would be my personal recommendation.

Protecting Mom's assets from Medicaid?

Essentially you are asking us, we taxpayers, to give you a way to keep your mother's assets from paying for her care while WE the taxpayers pay for her care?

Yes, there are definitely attorney's out there who will, for their OWN share of the pot, help you to "protect" or "hide" assets in special trusts. They are tricky. Not the attorneys, necessarily, but the trusts. So take care that, in "protecting" you don't lose a lot. I wish you well.

Her assets are HERS for HER life and HER care.

I know it stinks not to be able to inherit the family home or the money, that's how life is supposed to work. We pay for our own care until we no longer have the resources.

We do not ask the taxpayer to pay for it so our children can get money later. This is why no financial planner will allow you to add an expected inheritance into your future plans.

The best way to handle this matter is to: (1) find a certified eldercare attorney; and (2) tell her or him that you do not know anything about qualifying your mom for Medicaid, so you need their guidance. Let them take over and guide you.

From Member Igloo from another thread:


igloo572
1 hour ago
Please pay attention as to what is being considered a “Trust”.

Asset Protection Trusts traditionally are a legal structure set up to enable assets to bypass probate & taxes. It’s estate planning. Trust owns assets; can have homes, land, etc titled in the Trust. Usually financial institutions need for Trusts to have as a baseline over 1M so that there is $ within Trust for investments that “feed” the Trust to pay costs that arise for titled assets. Like your great Aunt had a Trust with her home titled into it Trust but also stocks and oil royalties as well. Stocks & royalties as investments pay for costs (taxes, insurance, maintenance) on house & paid her $ periodically. Auntie died and she did the Trust to go to you as beneficiary so you can stay at the house & you too can get $ periodically. Those stocks “feed” it $ & hopefully Trust does this for your kids. It’s Asset Protection & what intergenerational wealth in the US is based on.

This is the type of Trusts associated with wealth & security.
With Trustees, tax filings, attorneys & financial institutions.
But there are other kinds of Trusts…..

Like SNT = Special Needs Trusts set up for those with disabilities. Done by attorneys or by outreach groups.

Testamentary Trusts - in a will for how distribution of assets to be done.

IFT = Irrevocable Funeral Trusts. Often sold under different names, &
what they seem to be are basically a type of life insurance policy that you buy to have preneed funeral or burial space that is placed into a contract funded Trust drawn upon to pay for funeral / burial once you die. It’s IRREVOCABLE, so once bought, $ is gone completely. The $ goes to the funeral stuff only, so you need it for something else, too frickin’ bad. Most State LTC Medicaid have a maximum $ allowed on IFT. & States can have other restrictions on them as well.
Like TX has 15K max, a specific Goods & Services list and all $ not used MUST escheat (be sent) to the State. It’s an insurance product so often touted as being at no fee, which it is, as insurance policies usually paid via a commission. Ask for in writing - exactly- the commission structure on the premium. You may be surprised how high it is.

PNA trust - Personal Needs Allowance trust. The $ an individual in a NH on LTC Medicaid is allowed to keep from their income each month to use for items not covered by Medicaid (snacks, magazines, beauty shoppe). If NH is their representative payee for SS, PNA $ is required to be placed into a trust account at the NH with interest paid. It’s actually called an “Trust” although it can be a small amount of $. PNA varies by State. Like AL & NC are low at $30 a mo, AZ is high at $137.10. NYS is $50 mo. All other income is a copay as the required SOC share of cost to the NH.
POA does need to be mindful of PNA trust $ as count towards assets. Assets have max allowed per mo & amount depends on your State.

If you’re not sure IF it’s something being touted as a TRUST is ok for LTC Medicaid, that’s something to get clear answers from your moms Medicaid caseworker in advance. If there is an issue, it’s an eligibility problem for her, not for whoever sold you the product.
AND
super important to know difference between revocable versus irrevocable. Could be a huge & costly mistake.

From reading some of the responses here I'm not sure everyone understands what the rules and qualifications are for becoming eligible for Medicaid (LTC kind of Medicaid) and what is allowed as far as assets and how trusts come into play. I don't have all the answers either, but I'm pretty sure that if you want to protect your assets and leave them to you kids or others, you must transfer those assets into an irrevocable trust at least 5 years before you need long term care Medicaid. If you don't meet that 5 year lookback period Medicaid will not approve you or give you a penalty that you must pay before Medicaid will pay for your care. Medicaid will allow you to set up a trust for funeral and burial expenses however (up to a certain amount), so for that it may be useful for an attorney to set that up for you. There are also laws to protect the spouse or possibly a disabled child to be able to stay in the home and have a portion of the LO's income go to them instead of the nursing home. Other than that, you really can't "cheat" the system. You really can't "protect" mom's assets. They will be used for her care, unless she transfers those assets to an irrevocable trust at least 5 years prior to needing nursing home, and in that case, what you are really doing is protecting your own inheritance at the expense of having better care/comfort for mom when she needs it.

Some people feel resentful because they believe they worked hard and scrimped and saved, and now all that money is in jeopardy of being used up quickly for nursing care, while others who weren't so frugal or didn't earn enough money in decent paying jobs, or maybe squandered away their money on drugs, alcohol or gambling are able to get Medicaid. I get it. You at least however can benefit from your savings by having more comfortable private pay facilities available to you for some period of time.

Not sure with Dementia Mom can set up a trust. She has to understand what she is doing. Do you have POA? If so, see if it gives you the ability to set up a trust. IMO if it does, its kind of a conflict of interest, meaning you profit from the trust not her.

If your Mom needs Memory care, then its too late for a Trust. And I would so rather her spend her money on a nice place to live, then be on Medicaid. My Mom was in her last stage of Dementia when she entered LTC. It was a nice place and she was well cared for. She paid privately for 2 months and then she went on Medicaid. She was not in her room during the day because she was out in the common area. She only slept in her room at night. So I did not say much when she was transferred to a 4 bed room. Medicaid they must have a 2 bed room at least.

In my State if you pay for an AL or MC for at least two years, you can apply for Medicaid if you have no more money for your care and stay in that facility but the facility has to except Medicaid. So find out what your State allows in Medicaid paying for MCs. If like my State, then find a facility that excepts Medicaid that way Mom does not have to move.

Yes, a trust can protect assets from Medicaid - However, it is not a straightforward process. There are restrictions as to the trust, to the healthy partners assets, if there is one, etc. You need to talk to an elder law attorney. However, make sure you have the attorney give you the full details of what to expect, what your responsibilities are, the total cost, when the process actually begins etc., prior to and after being qualified for Medicaid. Ask questions!
Depending on the age of the patient and her partner, plus the amount of assets and time involved, you need to weight the value of the cost of legal fees and what you'll be expected to do exactly, in order to become Medicaid qualified.
It is a complicated process, you need to know, up front what to expect - make sure, if you decide to go with it, that the attorney is a well known, highly recommended, well respected firm.